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Incidence of health problems in travelers to Southeast Asia: A prospective cohort study.

Phimphan Pisutsan,N. Soonthornworasiri,Wasin Matsee,W. Phumratanaprapin,Suda Punrin,W. Leowattana,Chayasin Mansanguan,E. Leshem,W. Piyaphanee

Published 2019 in Journal of Travel Medicine

ABSTRACT

BACKGROUND There are few studies of the incidence of health problems among travelers to Southeast Asia. The current study sought to determine the incidence of self-reported health problems among travelers visiting the region. METHODS A prospective questionnaire-based study was conducted among travelers from high income countries who visited Southeast Asia. Participants were enrolled at time of their pre-travel visit at Mahidol University, Bangkok, Thailand. Travelers were prospectively followed by self-administered questionnaires two weeks after arrival, upon return to their home country, and two weeks after return. RESULTS During January 2018-February 2019, 359 travelers were enrolled in Bangkok, Thailand, and the first questionnaire was administered. Follow up questionnaires were returned by 191, 96, and 64 participants two weeks later, at the end of the trip and two weeks after return respectively. A total of 6,094 travel days were included in the final analysis. The incidence of acute diarrhea per month per 1,000 travelers was 217 (95% confidence interval (95%CI 189-248) episodes; skin problems 197 (95%CI 170-227); respiratory symptoms 133 (95%CI 111-158); fever 49 (95%CI 36-65); and potential rabies exposure 34 (95%CI 24-48). The incidence of acute diarrhea episodes per month per 1,000 travelers was significantly higher during the first two weeks of travel compared with subsequent weeks of travel: 325 (95%CI 291-362) versus 132 (95%CI 110-1157), (p<0.05). The incidence of outpatient visits and hospitalizations per month per 1,000 travelers was 49 (95%CI 36-65) and 5 (95%CI 2-10) respectively. CONCLUSION In this prospective cohort study we observed substantial burden of acute diarrhea, skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.

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